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Paediatrics
Published in Vincent Helyar, Aidan Shaw, The Final FRCR, 2017
This is the most common cyanotic heart disease to present at birth. It is more common in male children of diabetic mothers. Presentation is with cyanosis and heart failure. The aorta is connected to the right ventricle and supplies the systemic circulation; the pulmonary artery arises from the left ventricle. In total, 90% are isolated abnormalities.
The neonate
Published in Louise C Kenny, Jenny E Myers, Obstetrics, 2017
Cyanosis can indicate respiratory failure or a structural heart condition that prevents blood getting into the lungs to be oxygenated. In respiratory failure there is usually a failure in ventilation as well as in oxygenation, in which case there is respiratory acidosis that requires significant support with a ventilator. Giving extra oxygen will usually change the oxygen saturation in respiratory failure. In contrast, cyanotic heart disease will have a much greater deficit in oxygenation and increasing inspired oxygen does not make a difference to oxygen saturation. Causes of early cyanotic heart disease include transposition of the great arteries, atresia or stenosis of the pulmonary valve (including tetralogy of Fallot and double outlet right ventricle with severe pulmonary stenosis) and totally anomalous pulmonary venous drainage.
Station 3: Cardiology
Published in Saira Ghafur, Parminder K Judge, Richard Kitchen, Samuel Blows, Fiona Moss, The MRCP PACES Handbook, 2017
Saira Ghafur, Parminder K Judge, Richard Kitchen, Samuel Blows, Fiona Moss
What is Eisenmenger’s syndrome? Eisenmenger’s results from a large left-to-right shunt/cardiac defect causing increased pulmonary blood flow, pulmonary vessel injury, increased pulmonary vascular resistance and resultant pulmonary hypertension.This leads to reversal of the shunt, causing either a unidirectional right-to-left shunt or a bidirectional shunt.This is clinically manifest as cyanotic heart disease.
Tetralogy of Fallot with isolated levocardia in a young female
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Zeeshan Sattar, Hafez Muhammad Abdullah, Sohaib Roomi, Waqas Ullah, Adnan Khan, Ali Ghani, Asrar Ahmad
A 19-years old girl from Afghanistan, who had been diagnosed with a cyanotic heart disease at an early age when a heart murmur and cyanosis were detected, presented with shortness of breath and acral cyanosis. Throughout her life, she had been experiencing increasing exercise intolerance, frequent episodes of cyanosis and substantial shortness of breath upon exertion. She had no chest pain or palpitations. Her medical history was otherwise notable only for recurrent chest infections i.e. pneumonia several times. Because of limited access to medical care, she had not undergone any medical therapy or surgical treatment for her cardiac condition. In April 2015 she was referred to Pakistan for treatment of her condition as it was worsening. Her body weight and height were normal and according to her age.
Sudden onset polyarthritis as a paraneoplastic syndrome from non-small cell lung cancer
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Keshav Poddar, Leena Pathikonda, Miguel Villamil
Hypertrophic osteoarthropathy (HOA) is a rare paraneoplastic disease that can be extremely debilitating and usually resolves with treatment of the underlying lung pathology or with bisphosphonates. It develops due to underlying pulmonary pathology, most commonly a malignancy [1]. Eighty percent of cases are caused by a paraneoplastic syndrome, more commonly by non-small-cell lung cancer and less often by small-cell lung cancer [2]. The remaining 20% of cases can be caused by chronic respiratory disease, congenital cyanotic heart disease, chronic inflammation, or congenital pachydermoperiostosis [3,4]. It is sometimes the first sign of malignancy, so physicians should maintain a high index of suspicion when encountered with sudden arthritis, especially in a smoker [5,6].
Clinical outcomes for congenital heart disease patients presenting with infective endocarditis
Published in Expert Review of Cardiovascular Therapy, 2020
For many years prior to the revision of the most recent IE prophylaxis guidelines, congenital heart disease has been classified into three groups: High risk group including cyanotic heart disease, history of IE, valve prostheses, heart disease operated on with residual lesions and during the 6 postoperative months.Moderate risk group including high-speed shunts and nonoperated native mitral and aortic valve disease.At little or no risk group including mainly atrial septal defect.